How cancer can affect your sexuality and sex life

Effects on sexuality and sex life

Not everyone with cancer will have changes in sexual desire or how they feel about themselves sexually. You might not notice any changes at all. But you might find cancer changes your body image affecting the way you feel about yourself and sex.

Some people lose interest in sex and feel very tired. But some people say that they want to have sex more than usual. If you are in a relationship, a crisis can sometimes bring couples very close together.

As people are so different and have different sexual needs, it is impossible to say exactly how cancer will affect your sexuality and sex life. Some types of cancer and their treatment affect your ability or desire to have sex more than others. If you are in a loving relationship your concerns may be different from someone who is single.

If your feelings about your body and having sex change during your cancer treatment, it doesn't mean that it will last forever. If you are able to talk to your partner, doctor or nurses about your worries it can ease them. They may be able to suggest ways to help improve any problems you're having.

You might not feel like having sex if you have any of these side effects or feelings. Some people say they feel less attractive because of them. You might not have the energy to take as much interest in your clothes, hair, make up or grooming as you did before.

If you are the partner of someone in this situation, you might be very worried about your partner seeming so low. This is understandable. But many people feel better once their treatment is over, or their symptoms are better controlled.

Painkillers

If you have a lot of pain because of your cancer it can help to plan for any sexual activity, for example by taking painkillers 30 to 60 minutes beforehand.

Tiredness (fatigue)

This might last for some time after your cancer treatment has finished. Many people feel stronger within a couple of months of their treatment. But some people feel washed out for as long as a year, particularly if you have intensive chemotherapy.

You might not feel like having sex if you are very tired. Simply touching can help you feel cared for and reduce any anxiety and depression you may have.

Alternatives to sex

If you have a partner, you can focus on showing your feelings for one another in other ways by:

enjoying being close to each other

touching and stroking

kissing

massaging

talking

holding hands

Even if you do not feel like having sex, a partner might still be able to arouse you and help you enjoy sexual activity.

It is important to agree on what is acceptable to each of you. Talk to each other about your worries and fears. Do not be afraid to tell each other what you like, and don't like. Talking about sex can be difficult, but talking about feelings and what you each want can be very reassuring.

How practical issues can affect your sex life

Practical issues include worries about your job or money, or problems with everyday activities such as picking children up from school or shopping. These problems can be very stressful.

If your cancer means you have to stop work, you still need a regular income to pay your bills and any extra costs relating to your illness. If you have to deal with the stress of not having enough money, it can cause a lot of conflict within relationships and intimacy can suffer.

Cancer symptoms and treatment side effects can sometimes make it very difficult to keep up your normal daily routine, especially if you have children. At times you might have to organise other people to look after them. You might be concerned about how your cancer is affecting your children. Or you might have to ask close friends and family to help out with your shopping and cooking.

It can be hard to find energy or desire to be intimate with a partner if practical issues are worrying you. It might all just feel too overwhelming to try to relax and enjoy sexual activity. But it is very important to try and talk to your partner about your concerns and find ways to sort through any problems.

Try to find a quiet time together when you can talk openly and honestly about your worries. Listen to each other and try to find solutions to your problems. Even though it might be difficult to stay calm and talk about problems in a rational manner, you might be surprised at how much it helps. It might even bring you closer together.

Loss of confidence and self esteem

Cancer and its treatment can change the way you feel about yourself (your self esteem). This might be because of physical changes to your body or it might be about less obvious changes.

The intense emotions that cancer can cause might also lower your self esteem. You might feel that you have lost some of your independence and can't do things you used to enjoy.

You might feel so tired and worried that activities you used to find easy now seem too difficult to do. Your future plans might have to be put on hold. You might begin to feel you have no control over your life. All these things can make you feel less confident about who you are and what you do. Having confidence and a healthy self esteem are very important to us all. They play a big part in our sexuality and sex life.

Self esteem also means self satisfaction, self respect and self worth. Many factors can affect these feelings, including illnesses such as cancer that threaten your physical health. Having a low self esteem can affect your quality of life. It can cause long term problems such as depression and anxiety. You are less likely to feel intimate and sexual if you feel depressed or anxious.

It can be very difficult to boost your self esteem when you feel so low. But there are things that you can do. The most important thing is to talk to someone about how you are feeling. This can be relative or friend, or your doctor or nurses. Just talking about your feelings can help you to feel better.

Give yourself some time to come to terms with all you have been through. It will take time to raise your confidence and self esteem again. But it is possible.

Changes in your body image

Cancer treatment can also change how you see yourself in more obvious ways. Changes in how you feel about your body may not directly affect your ability to have sex. But they can definitely make you feel less sexual.

Changes might include:

hair loss from radiotherapy or chemotherapy

having a colostomy or urostomy (a bag for bowel movements or passing urine)

having a breast removed (mastectomy)

having your womb removed (hysterectomy)

having a testicle removed

having vaginal surgery

having vulval surgery

having your cervix removed

having surgery for bladder cancer

having surgery for penile cancer

a change to your appearance from head and neck cancer

scarring from surgery

weight loss

weight gain from taking drugs such as steroids

Some of these changes can be temporary. Your hair will grow back after chemotherapy. You might put on weight when taking steroids, but lose it again when your treatment is finished. It might only be a matter of time before you get back to what is normal for you.

Some people believe their past sex life has helped cause their cancer. This worry or guilt can make future sexual activity difficult. Many people with worries like these find it helpful to talk to someone about their fears.

Some people have a feeling of being unclean after treatment. It is important to acknowledge how powerful these feelings can be. It might be helpful to talk your fears through with a sympathetic person who can reassure you.

You will have to come to terms with the changes to your body if your treatment effects are more permanent, such as having a breast removed or having a permanent colostomy. Some people find this more difficult than others, and it might take some time. It might help to talk to other people who have been through the same thing. Counselling might help to explore your feelings in more depth.

Emotional and psychological changes

Cancer can change you physically and cause many emotions such as fear, depression and anger. These intense feelings might also affect how you feel about sex and about yourself.

You might find that you look at the world differently after having cancer. Some people find they can use cancer as a new beginning. However your outlook on life changes, you and the people close to you will need time to get used to it.

If you're single

Feeing attractive to others and sexual might be important whether you are in a relationship or not. This means getting used to changes yourself first. It can be a little more difficult if you don't have a partner to support you. It might be helpful to talk to a relative or friend.

Getting help and support

Many problems with sex after cancer will get better with time and a little patience. There is help available for you.

Remember problems with sex are very common, even for people who do not have cancer. They are just not always talked about much.

Talking about sex can be difficult and many people find it very embarrassing. It might take courage to bring the subject up. Sometimes your questions can be answered there and then. If not, or if you feel that your cancer doctor or nurse is uncomfortable talking about sex, then you can ask about finding a counsellor or therapist.

Talking to a counsellor or sex therapist can help you to find ways of overcoming difficulties. You can see a sex therapist if you are single. If you are in a relationship, you can go alone or with your partner. It might be useful to talk things through as a couple, if you can.

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